Analysis of pulmonary infections in patients with nasal feeding after acute aortic dissection operation

Han Yuehong; Shang Wei

doi:10.3760/cma.j.issn.1673-4777.2015.09.011

Abstract：Objective To explore the characteristics and risk factors of pulmonary infection in patients with nasal feeding after acute aortic dissection operation.Methods Clinical and bacteriology data of 72 patients with nasal feeding after acute aortic dissection operation from February 2010 to May 2013 were retrospectively analyzed.The patients were divided into pulmonary infection group and non-pulmonary infection group.The postoperative lactic acid level,postoperative complications,intensive care unit (ICU) time,length of trachea intubation time,length of hospital stay and death were recorded and compared between the two groups.Results The incidence of pulmonary infection was 40.3％ (29/72).The mortality of pulmonary infection group was significantly higher than that of non-pulmonary infection group [27.6％ (8/29) vs 9.3％ (4/43)] (P ＜ 0.01).Totally 62 strains were separated,including 40 strains of gram-negative bacilli (64.5％),14 strains of gram-positive (22.6％) and 8 strains of fungus (12.9％).The ICU time,length of trachea intubation time and length of hospital stay were significantly longer,meanwhile the postoperative lactic acid level and incidence of tracheotomy were significantly higher in pulmonary infection group compared with those in non-pulmonary infection group [(12-± 7) d vs (6±2) d,(8±6) d vs (5 ±1) d,(35 ±20) d vs (20 ±8) d 6,(7.5 ±4.2) mmol/L vs (5.4 ± 3.6) mmol/L,48.3％ (14/29) vs 11.6％ (5/43)] (P ＜ 0.01 or P ＜ 0.05).Logistic regression analysis showed that the increased lactic acid level and tracheostomy after operation were independent risk factors of pulmonary infection (P ＜0.05).Conclusion The hospital mortality is significantly increased in nasal feeding patients complicated with pneumonia after acute aortic dissection operation ; the increased blood lactic acid level and tracheostomy are independent risk factors of pneumonia; the gram-negative bacilli are main pathogens.